Hospital In Northern Italy Research Articles

Occurrence of monoclonal components in general practice: Clinical implications

We report on the occurrence of monoclonal components observed in a provincial hospital in northern Italy from 1987 to 1990. The monoclonal components were detected by visual inspection of high-resolution acetate serum electrophoreses and typed by immunofixation. The percentage of monoclonal components increases steeply with age, and reaches a plateau of 7-8% in individuals over 55 years old. Besides the high percentage of monoclonal component, the other relevant finding of this study is that approximately 80% of monoclonal components are of low concentration (less than 5 g/l). Most of these subjects with small monoclonal component passed undetected in the previous studies on the prognostic significance of monoclonal gammapathy. These findings indicate the need for a revision of the current concepts on the biological and clinical significance of MC discovered by chance.

Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis

Between 1987 and 1989 data were collected to evaluate risk factors for pelvic endometriosis. A case-control study was conducted on 241 cases with laparoscopically or laparotomically confirmed peritoneal or ovarian endometriosis consecutively admitted to three teaching hospitals in Northern Italy. The control group consisted of 437 women admitted to hospitals for acute conditions covering similar catchment areas. Compared with nulliparous women, the risk of endometriosis decreased with increasing number of births: the point estimates were 0.4 and 0.3, respectively, for those with one and two or more births (X2(1) trend = 50.3, P less than 0.001). No relation emerged with age at first birth and spontaneous miscarriages. Relative to women whose menarche occurred at age 11 or younger, the risk of endometriosis was slightly lower in those who experienced later menarche, but the trend in risk was not significant. Women with irregular menstrual cycles showed a lower frequency of the disease (relative risk, 0.3; 95% confidence interval, 0.2 to 0.5). The role of various factors was largely similar for different disease locations (ovary, peritoneum, and both) and indication for diagnostic surgery (sterility, pelvic pain, and other reasons). This study found that parity and irregular/long menses lower the risk of endometriosis. These findings were similar in different subgroups of disease location and indication for surgery, giving strong evidence of the consistency of the general results.

A prospective clinical and epidemiological study of head injuries in northern Italy: the Comune of Ravenna.

An analysis of all the head injuries occurring during one year within a well-defined geographical area was conducted in the region served by the Ravenna City Hospital in Northern Italy. This hospital does not have a neurosurgical service, so that patients suspected of having neurosurgical problems are transferred to the neurosurgical unit in Bologna, a distance of 65 Km (40 mi.). Of the 1468 head-injured patients seen in the emergency room, 644 (44%) were hospitalized, with an incidence of 372/10(5) pop/year) and were subjected to X-ray study of the skull (83%), EEG (64%), and CT scan (7.5%). 9 patients were transferred to the neurosurgical unit as emergencies on a clinical basis only, all were found to harbor cerebral lesions, and 7 were operated on. Of the patients hospitalized and subjected to CT scan in Ravenna, only one (0.17%) was found to have a lesion necessitating surgery. Mortality was 7.2% with 83% of these patients dying before admission. Three-month follow-up examination revealed the persistence of some symptoms in 20% of the 379 patients examined, but 91% had already returned to their previous occupation. Analysis of the risk factors present in the patients admitted to a non-specialized hospital seems to show that the presence of skull fracture, abnormal EEG, and alteration of the clinical condition constitute the indications for a CT scan, in order to detect the presence of intracranial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Endemic Strongyloidiasis in Northern Italy: Clinical and Immunological Aspects

One hundred and eighteen cases of S. stercoralis infection were detected by stool examination among 4203 patients seen over a period of three years at the Division of Infectious Diseases (IRCCS, San Matteo, University of Pavia) of a University Hospital in Northern Italy. Because chronic strongyloidiasis is often asymptomatic, a 3 per cent prevalence in this selected population indicates that the parasitosis may be much more frequent in the general population of the area. Parasite-specific humoral responses were studied in 48 patients. Strongyloides-specific IgG and IgA antibodies were found by ELISA in the serum of 40 (83.3 per cent) and 43 (89.5 per cent) patients, respectively, and specific IgE antibodies were detected by RAST in 39 (81.3 per cent). The specific IgG antigen recognition patterns of these patients were compared by immunoblotting with those of North and South American and Thai patients, and differences among the groups suggested the existence of separate geographic strains of S. stercoralis. This was further supported by the virtual absence in our patients of the larva currens, a common and highly characteristic sign of strongyloidiasis in subjects infected in southeast Asia. More awareness of the epidemiologic and clinical features of strongyloidiasis, with the use of serologic tests to screen candidates for immunosuppression, may result in the early detection of chronic uncomplicated strongyloidiasis and in the prevention of fatal opportunistic hyperinfections.

Subgrouping of human rotavirus strains by complement fixation, indirect double-antibody sandwich enzyme-linked immunosorbent assay and solid-phase immune electron microscopy

Complement fixation (CF), indirect double-antibody sandwich (DAS) enzyme-linked immunosorbent assay (ELISA) and solid-phase immune electron microscopy (SPIEM) were compared for their ability to subgroup 73 human rotavirus (HRV) strains from infants and young children with gastroenteritis admitted to one or the other of two different hospitals of Northern Italy. By both indirect DAS ELISA and SPIEM all 73 HRV strains were classified into one or the other of two subgroups. By CF only 67 strains could be subgrouped, as six HRV-positive stools showed anticomplementary activity which could not be eliminated. Indirect DAS ELISA required subgroup-specific, unabsorbed antisera from two different animal species. For SPIEM two antisera from a single animal species were needed, but they had to be absorbed with single-shelled bovine rotavirus for HRV subgrouping to be reliable. Indirect DAS ELISA appeared to be the technique most suitable for extensive application in epidemiological studies of HRV infections by different subgroups. However, SPIEM allowed rapid subgrouping of HRV in stool specimens showing anticomplementary activity in the CF test or non-specific reactions in the ELISA test. In one area of Northern Italy the prevalence of subgroup I HRV infections was 7.8 per cent, while in another it reached 68.1 per cent in the same period.